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Pros and cons · Renew Bariatrics
Gastric bypass and the duodenal switch both shrink the stomach and reroute the small intestine. The duodenal switch usually leads to more weight loss, while gastric bypass has fewer early complications and fewer vitamin problems. At Renew, the duodenal switch is done as SADI-S. Here’s how the two compare.
Renew offers both. SADI-S is performed by Dr. Héctor Pérez in Tijuana and Cancún.
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A coordinator will contact you about your options and quote, with no commitment.
Prefer to talk? Call (844) 736-3963, available 24/7.
Prefer to talk? Call 24/7 (844) 736-3963
Quick pros and cons
Both are done laparoscopically, through small incisions, and both are restrictive and malabsorptive. The best choice depends on your BMI, health conditions, reflux and how ready you are for lifelong vitamins.
76.0% of excess weight lost at 2 years, vs 68.1% after bypass, in a randomized trial (SADISLEEVE).
2.6% needed another operation within 30 days, vs 5.0% after SADI-S (MBSAQIP).
Higher odds of diabetes remission than bypass across 5 studies (meta-analysis).
Bypass is often advised for reflux. SADI-S starts with a sleeve, which can make reflux worse (SLEEVEPASS).
The pylorus stays in place, and the trial saw internal hernias only after bypass.
$6,299 at Renew, vs $6,899 for SADI-S.
How they work
Gastric bypass makes a small pouch at the top of the stomach and connects it to the small intestine, bypassing most of the stomach and the duodenum. SADI-S makes a sleeve, keeps the stomach valve, and connects the duodenum to a loop of small intestine further down, so more of the intestine is bypassed. Renew performs SADI-S, not the traditional duodenal switch (BPD-DS).
Side by side
| Gastric bypassRoux-en-Y | SADI-SSingle-anastomosis duodenal switch | |
|---|---|---|
| Stomach | A small pouch. The rest of the stomach stays in place but is bypassed | A sleeve. About 80% of the stomach is removed |
| Stomach valve (pylorus) | Bypassed | Kept |
| Surgeon at Renew | Our bariatric surgeons | Dr. Héctor Pérez, in Tijuana and Cancún |
| Operating time | 131 minutes (average) | 142 minutes (average) |
| Your stay at Renew | 2 hospital nights, 1 hotel night | 2 hospital nights, 1 hotel night |
| BMI range at Renew | 29.5 to 55 | 40 to 65 |
| Excess weight lost at 2 years | 68.1% | 76.0% |
| Another operation within 30 days | 2.6% | 5.0% |
| Leak within 30 days | 0.5% | 2.2% |
| Vitamins | Lifelong vitamins, including B12, iron and calcium | Lifelong vitamins, including A, D, E and K, with regular lab checks |
| Recovery | 2 to 4 weeks | 2 to 4 weeks |
| Cost with Renew Bariatrics | $6,299, all-inclusive | $6,899, all-inclusive |
| US self-pay cost | $19,000 to $28,000 | $25,000 to $35,000 |
2-year weight loss from the SADISLEEVE randomized trial, The Lancet, 2025, which randomized 381 patients with a BMI of 40 or more, or 35 or more with a related condition. Operating times and 30-day results from an MBSAQIP 30-day analysis, 2022 of 501 SADI-S and 46,874 bypass patients. These are averages from studies. Your results will be different.
Results
SADI-S led to more weight loss than gastric bypass in a randomized trial and in a review of studies with longer follow-up. In the first 6 months, results in US registry data were about the same.
Health conditions
Both surgeries improve type 2 diabetes, high blood pressure and sleep apnea. In a 2025 review of 8 studies with 4,259 patients, diabetes remission was more likely after SADI-S (odds ratio 3.48) (meta-analysis of 8 studies, Obesity Surgery, 2025). Reflux is different: gastric bypass is often used to treat it, while SADI-S includes a sleeve, which can cause new reflux or make it worse.
Complications
Both surgeries carry risks of bleeding, leaks and nutritional deficiencies. Dumping syndrome, ulcers and internal hernias are mainly seen after gastric bypass. Looser stools are more common after SADI-S, and deficiencies of protein and fat-soluble vitamins are a bigger concern (ASMBS nutrition guidelines). In the SADISLEEVE trial, serious events after SADI-S included 3 leaks and 8 cases of severe diarrhea, and after bypass, 5 internal hernias (SADISLEEVE randomized trial, The Lancet, 2025).
Which is right for you?
You have reflux (GERD).
You have a BMI of 29.5 to 55.
You want fewer early complications and a lower price.
You have a BMI of 40 to 65 and want the most weight loss.
You have type 2 diabetes that’s hard to control.
You’re ready for lifelong vitamins and regular lab checks.
You can also compare the sleeve and gastric bypass, the mini gastric bypass, or all 11 procedures we offer.
Cost
At Renew, gastric bypass is $6,299 and SADI-S is $6,899, both all-inclusive except airfare. HSA and FSA are accepted, with financing available.
Send your health history and our surgeons will review your options. Virtual consultations are available.
5-star Google reviews. Want to talk with a past patient? Ask your coordinator.
“Renew has been wonderful. With the bypass, although any procedure hurts, I’m positive in the long run it will be worth it. The facility in TJ is clean and the nurses are very kind.”
“Dr. Perez and his staff with Renew Bariatrics were phenomenal. My only regret is not getting this done sooner. Thank you for giving me the tool that will change my life. I am forever grateful.”
“This experience has been more than incredible. From the moment our driver picked us up we have been treated first class. Dr Perez has seen us multiple times and every single time he has been warm, gracious, and encouraging. You have made the journey to a more healthy lifestyle possible!”
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Neither is better for everyone. SADI-S leads to more weight loss and has a stronger effect on diabetes. Gastric bypass has fewer early complications, fewer vitamin problems and is usually better if you have reflux. Our surgeons will recommend one after reviewing your health history.
In the SADISLEEVE randomized trial, patients lost 76.0% of their excess weight 2 years after SADI-S vs 68.1% after bypass.
In the first 30 days, yes. In US registry data, 5.0% of SADI-S patients needed another operation vs 2.6% after bypass, and leaks were more common.
Usually gastric bypass. SADI-S starts with a sleeve, which can cause new reflux or make it worse.
No. Renew performs SADI-S, a single-connection version of the duodenal switch, with Dr. Héctor Pérez. We don’t perform the traditional BPD-DS.
Yes, for life after both. SADI-S needs closer monitoring, including vitamins A, D, E and K. Gastric bypass needs B12, iron and calcium, with regular lab checks.
Gastric bypass is $6,299 and SADI-S is $6,899, both all-inclusive except airfare. HSA and FSA are accepted, with financing available.
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Double board-certified surgeons with 9,000+ surgeries.
Prefer to talk? Call 24/7 (844) 736-3963
Free, no-obligation review
Form loading. Prefer to talk? Call (844) 736-3963, available 24/7.
No commitment. A coordinator will contact you.
